Gao Wen, Cui Zhengzhe, Yu Yang, Mao Jing, Xu Jun, Ji Leilei, Kan Xiuli, Shen Xianshan, Li Xueming, Zhu Shiqiang, Hong Yongfeng
Department of Rehabilitation Medicine, The Second Hospital of Anhui Medical University, No. 678 Furong Road, Economic and Technological Development Zone, Hefei 230601, China.
Zhejiang Laboratory, Department of Intelligent Robot, Keji Avenue, Yuhang Zone, Hangzhou 311100, China.
Brain Sci. 2022 Aug 16;12(8):1083. doi: 10.3390/brainsci12081083.
(1) Objective: To investigate the feasibility, safety, and effectiveness of a brain-computer interface (BCI) system with visual and motor feedback in limb and brain function rehabilitation after stroke. (2) Methods: First, we recruited three hemiplegic stroke patients to perform rehabilitation training using a BCI system with visual and motor feedback for two consecutive days (four sessions) to verify the feasibility and safety of the system. Then, we recruited five other hemiplegic stroke patients for rehabilitation training (6 days a week, lasting for 12-14 days) using the same BCI system to verify the effectiveness. The mean and Cohen's w were used to compare the changes in limb motor and brain functions before and after training. (3) Results: In the feasibility verification, the continuous motor state switching time (CMSST) of the three patients was 17.8 ± 21.0s, and the motor state percentages (MSPs) in the upper and lower limb training were 52.6 ± 25.7% and 72.4 ± 24.0%, respectively. The effective training revolutions (ETRs) per minute were 25.8 ± 13.0 for upper limb and 24.8 ± 6.4 for lower limb. There were no adverse events during the training process. Compared with the baseline, the motor function indices of the five patients were improved, including sitting balance ability, upper limb Fugel-Meyer assessment (FMA), lower limb FMA, 6 min walking distance, modified Barthel index, and root mean square (RMS) value of triceps surae, which increased by 0.4, 8.0, 5.4, 11.4, 7.0, and 0.9, respectively, and all had large effect sizes (Cohen's w ≥ 0.5). The brain function indices of the five patients, including the amplitudes of the motor evoked potentials (MEP) on the non-lesion side and lesion side, increased by 3.6 and 3.7, respectively; the latency of MEP on the non-lesion side was shortened by 2.6 ms, and all had large effect sizes (Cohen's w ≥ 0.5). (4) Conclusions: The BCI system with visual and motor feedback is applicable in active rehabilitation training of stroke patients with hemiplegia, and the pilot results show potential multidimensional benefits after a short course of treatment.
(1) 目的：探讨具有视觉和运动反馈的脑机接口（BCI）系统在脑卒中后肢体和脑功能康复中的可行性、安全性和有效性。(2) 方法：首先，招募3例偏瘫脑卒中患者，使用具有视觉和运动反馈的BCI系统连续两天（共四节训练课）进行康复训练，以验证该系统的可行性和安全性。然后，招募另外5例偏瘫脑卒中患者，使用同一BCI系统进行康复训练（每周6天，持续12 - 14天），以验证其有效性。采用均值和科恩w值比较训练前后肢体运动和脑功能的变化。(3) 结果：在可行性验证中，3例患者的连续运动状态切换时间（CMSST）为17.8±21.0秒，上肢和下肢训练中的运动状态百分比（MSP）分别为52.6±25.7%和72.4±24.0%。上肢和下肢每分钟的有效训练转数（ETR）分别为25.8±13.0和24.8±6.4。训练过程中未出现不良事件。与基线相比，5例患者的运动功能指标得到改善，包括坐位平衡能力、上肢Fugel - Meyer评估（FMA）、下肢FMA、6分钟步行距离、改良Barthel指数以及腓肠肌的均方根（RMS）值，分别提高了0.4、8.0、5.4、11.4、7.0和0.9，且均具有较大的效应量（科恩w≥0.5）。5例患者的脑功能指标，包括非病变侧和病变侧运动诱发电位（MEP）的波幅，分别增加了3.6和3.7；非病变侧MEP的潜伏期缩短了2.6毫秒，且均具有较大的效应量（科恩w≥0.5）。(4) 结论：具有视觉和运动反馈的BCI系统适用于偏瘫脑卒中患者的主动康复训练，初步结果显示在短疗程治疗后具有潜在的多维度益处。
